Individual
CRISTON A MENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
408 N MAIN ST STE F, ROCKY FORD, CO 81067-1256
(719) 423-8834
(719) 316-2753
Mailing address
1100 HOPKINS AVE, ROCKY FORD, CO 81067-2421
(719) 696-0910
(719) 316-2753
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0009923059
CO
1041C0700X
Clinical Social Worker
Primary
CSW.09928454
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14671305
CAQH
—
Enumeration date
07/21/2020
Last updated
08/08/2022
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